SmokingCessationFC Flashcards
(49 cards)
general tx algorythm for tobacco
- use one singe agent
- Use 2 nicotine products
- Use nicotine product +buproprion
- 2 nicotine products plus bupoprion.
required vaccines for smokers
pneumococcal (23) and Flu each fall
The 5 A’s
Ask about tobacco use
Advise to quit
Assess (ready to quit? / challenges)
Assist (w/ meds)
Arrange (F-)
Nicoderm CQ
that is th patch
habitrol
nicotine patch
Commit
nicotine lozenge
nicorelief and Nicorrette
nicotine gum or lozenge
Nicotine Replacement Therapy (NRT) routes
Nicotine gum THRIVE
Nicotine inhaler
Nicotine nasal spray
Nicotine patch Nicoderm CQ
Nicotine lozenge (COMMIT) BRAND NAME
what are the OTC NRT brands
Nicorette, Nicorelief, Thrive
SE OF OTC brands of NRT
Side effects: dyspepsis, mouth soreness, hiccups, jaw aches
CI OF OTC brands of NRT
-CI: recent MI (within 2 weeks), life-threatening arrhythmia, severe or worsening angina, pregnancy
what dose of nicotine to use if pt > 25 cig/day
-Use 4mg if smoke >25 cigs/day
advantage of brands of OTC NRT
Reduces or delays weight gain
Counseling for Gum (THRIVE)
how to chew park
what types of food interefere
-Gum should be chewed slowly until “peppery” or “flavored” taste emerges, then “parked” between cheek and gum to facilitate nicotine absorption through the oral mucosa (30 mins)
-Acidic beverages interfere with the buccal absorption of nicotine, so eating and drinking anything except water should be avoided for 15 mins before and after
how ofte should patients be using the gums?
-Patient often do not use enough gum to obtain optimal clinical effects. Instruct to use at least 1 piece q1-2h
nicotrol inhaler OTC or RX ?
Rx
why is it good? The nicotrol inhaler?
mimics the smoking action and provides coping mechanism
SE of nicotrol inhaler
Side effects: local irration in the mouth and throat, coughing, rhinitis, headache
CI to nicotrol inhaler
-CI: recent MI (within 2 weeks), life-threatening arrhythmia, severe or worsening angina, pregnancy
Counseling for nicotrol inhaler
-Frequent, continuous puffing for 20 mins
-Only good for one day. 1 cartridge= 1 day
Clean mouthpiece with soap and water regularly
in cold weather, the inhaler and cartridge should be kept in an inside pocket or other WARM areas
-Acidic beverages interfere with the buccal absorption of nicotine, so eating and drinking anything except water should be avoided for 15 mins before and after
Nicotrol Nasal Spray
adr
ci
adv fastest or slowest?
avoid in
RX
Side effects: nasal irritation, nasal congestion, changes in taste and smells
CI: recent MI (within 2 weeks), life-threatening arrhythmia, severe or worsening angina, pregnancy
Fastest delivery system (rapid relief)
Avoid in severe reactive airway disease
Counseling for Nasal Spray
Patient should not sniff, swallow, or inhale through the nose while administering doses, as this increases irritating effects
the spray is best delivered with the head tilted slightly back
Nicotine Patch
Se
ci
Dose
how to change dose if sleeping issues
OTC or Rx
Side effects: local skin reactions, insomnia, vivid dreams
CI: recent MI (within 2 weeks), life-threatening arrhythmia, severe or worsening angina, pregnancy
Use 21mg if smoke >10 cigs/day
-Worn for 24 hours, or for 16 hours to avoid insomnia
Counseling for Patch
as soon as Patient wakes in morning, place the patch on a relatively hairless area, typically between the neck and waist, rotating the site to reduce irritation
use hydrocortisone or triamcinolone for skin irriation
